Sleep disorder or simple sleep ontogeny? Tendency for morningness is associated with worse sleep quality in the elderly

Abstract

The objective of this study was to evaluate the alterations in sleep and circadian parameters during the aging process. The study sample comprises volunteers older than 18 up to 90 years of age that answered the Pittsburgh Sleep Quality Index (PSQI) and the Horne and Östberg circadian preference questionnaire. We observed that the shift to morningness with increasing age is associated with a significant worsening in sleep quality. We discuss that this sleep profile characterized by morningness and worse sleep quality observed in elderly, when compared to younger people, reflects not necessarily a pathological state, but an expected profile for this age group.

What do sleep diaries tell us about patients diagnosed with chronic insomnia?

“…Our results also seem to be in line with previous studies (Barbosa, Miguel, Tufik, Sabino, Cendoroglo, & Pedrazzoli, 2016;Crowley, 2011) that showed a tendency towards morningness in older age, as well as an increase on the number of awakenings experienced during the night. We also found a tendency following the increasing age to spend more time awake during the night (probably a consequence of an increased number of awakenings), feel more rested upon waking up, sleep less, and have a lower sleep efficiency.…”

Longitudinal analysis of risk factors for dementia based on Mild Cognitive Impairment Screen results and questionnaire responses from healthy Japanese individuals registered in an online database

“…Sleep in the elderly is characterized by short sleeping hours, lack of continuous sleep, and early wakefulness, that is, the elderly wake up earlier than young people [16] . As reported by Yo-El et al.…”

Circadian Rhythms, Sleep, and Aging

“…Circadian rhythms usually weaken with aging (Pandi-Perumal et al, 2010; Schmidt et al, 2012), most likely with some relationship with the general CNS deterioration and in parallel with the decreased response to external time cues and melatonin secretion. Evidence from animal studies indicates that the activity of the SCN governing the circadian system is reduced with aging and the clock gene expression is altered (Asai et al, 2001; Barbosa et al, 2016; Carrier et al, 1999; Hunt et al, 2015; Kim & Duffy, 2018; Roozendaal et al, 1987; Yamazaki et al, 2002). In the elderly without sleep disorders of medical relevance or induced abnormal sleep/wakefulness rhythms, the circadian indicators of the sleep-wakefulness rhythm (sleep onset and offset), melatonin (onset), and cortisol (acrophase) become active earlier during the day (Hagenauer et al, 2009).…”

“…The sleep-wakefulness alternation is the main expression of the circadian cycle and is crucial in adaptation and to health (Bass, 2012; Gamble et al, 2014; Kriegsfeld & Silver, 2006; Nitabach, 2005; Panda et al, 2002; Reppert & Weaver, 2002; Schibler, Ripperger & Brown, 2003). Disordered circadian processes at central and/or cellular levels and (disordered or induced) unhealthy wakefulness/sleep rhythms can impair (or disarrange the life rhythms with respect to) the physiological circadian organization and result in subjective, professional, or behavioral changes ranging from functional inadequacy to medical relevance (Asai et al, 2001; Barbosa et al, 2016; Hunt et al, 2015; Kim & Duffy, 2018; Yamazaki et al, 2002; see Garbarino et al, 2016, 2019 for references). Circadian arrangement and sleep organization change ontogenetically; major changes result from normal aging and from the multiple diseases often associated with aging.…”